{extends file="./main.tpl"}
{block name=head}
<script type="text/javascript">
  $(document).ready(function() {
    $('#fName').focus();
  });
</script>
{/block}
{block name=body}
<form name="form1" method="post" action="register.php">
<table class="table1" width="300" border="0" align="center" cellpadding="0" cellspacing="1">
<tr>
  <td>
    <table class="" width="100%" border="0" cellpadding="3" cellspacing="1">
  <tr>
    <td colspan="3" align="center"><h2>Register</h2></td>
</tr>

   <div class="clr"></div>
<tr>
  <td NOWRAP style="font-size:18px">First Name :</td>
  <td><input  type="text" name="fName" class="text1" autofocus=autofocus required></td>
</tr>
<tr>
  <td NOWRAP style="font-size:18px">Middle Name :</td>
  <td><input  type="text" name="mName" class="text1" required></td>
</tr>
<tr>
  <td NOWRAP style="font-size:18px">Sur Name :</td>
  <td><input  type="text" name="sName" class="text1" required></td>
</tr>
<tr>
<tr>
  <td style="font-size:18px">Gender :</td>
  <td><input type="radio" name="gender"  checked="checked" value="Male"><b>Male</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
      <input type="radio" name="gender" value="Female"><b>Female</b></td>
</tr>
<tr>
  <td NOWRAP style="font-size:18px">City :</td>
  <td><input  type="text" name="city" class="text1" required></td>
</tr>
<tr>
  <td NOWRAP style="font-size:18px">Address :</td>
  <td><textarea name="address" rows="6" cols="10" class="textarea1" required></textarea></td>
</tr>
<tr>
  <td NOWRAP style="font-size:18px">Postal Code :</td>
  <td><input  type="text" name="postalCode" class="text1" required></td>
</tr>
<tr>
  <td NOWRAP style="font-size:18px">Contact No :</td>
  <td><input  type="text" name="contactNo" class="text1" required></td>
</tr>
<tr>
  <td NOWRAP style="font-size:18px">Website :</td>
  <td><input  type="text" name="webSite" class="text1" required></td>
</tr>
<tr>
  <td NOWRAP style="font-size:18px">E-mail :</td>
  <td><input  type="text" name="email" class="text1" required></td>
</tr>
<tr>
  <td NOWRAP style="font-size:18px">User Name :</td>
  <td><input  type="text" name="userName" class="text1" required></td>
</tr>	
<tr>
  <td NOWRAP style="font-size:18px">Password :</td>
  <td><input  type="password" name="password" class="text1" required></td>
</tr>	
  <td colspan="3" align="center"><input type="submit" name="Submit" class="" value="R E G I S T E R">
  </td>
</tr>
</table>
  </td>
 
  </tr>
</table>
</form>
{/block}
